Triglycerides- What are they?

According to the British Heart Foundation, more than a quarter of all deaths in the UK (27 per cent) are caused by cardiovascular (heart and circulation) disease. With over 155,000 deaths occurring each year, heart health has never been of greater importance. While many people are increasingly monitoring their blood pressure and cholesterol levels, there is another factor people should be considering – their triglyceride levels.

Triglycerides are a type of lipid or fat that is found in your blood. When you eat, your body converts calories it doesn't immediately need into triglycerides, which it stores in your fat cells to use for energy later. A high level of triglycerides in your blood can significantly increase your risk of heart disease.

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What are the expected levels?

The following table outlines the expected levels of triglycerides in the blood; categorising levels from normal to very high

Category Milligrams per deciliter (mg/dl) Millimoles per litre (mmol/L)
Normal Less than 150 Less than 1.7
Borderline 150 to 199 1.8 to 2.2
High 200 to 499 2.3 to 5.6
Very High 500 or above 5.7 or above

Difference between triglycerides and cholesterol

Triglycerides and cholesterol are both types of lipids or fats that cannot dissolve in the blood and circulate through the body via transporting lipoproteins. But they differ in their function. Triglycerides' purpose is to store up energy for the body, which can be used later when needed. Cholesterol's function is to build cells and certain hormones in the body. Within normal ranges, both are essential for a healthy body. But, if levels reach too high they can cause heart disease and cause other long-term damage to your health.

Diagnosing high triglycerides levels

A simple blood test, often referred to as a lipid panel, can diagnose high triglyceride levels and can be checked at the same time as cholesterol levels. To get an accurate triglyceride level measurement, you will need to fast from 9 to 12 hours before the test.

As well as contributing to atherosclerosis (a hardening of the arteries) and heart disease, very high triglycerides levels (more than 1,000 mg/dl) can also cause acute pancreatitis. If you're diagnosed with high triglycerides levels, it can be a warning of:

  • Obesity or metabolic syndrome that can also cause heart disease or stroke
  • Type 2 Diabetes that is being poorly controlled
  • Hypothyroidism – low levels of thyroxine
  • Liver or kidney disease
  • Rare genetic conditions affecting how your body converts fats
  • Certain medications causing side effects - such as alpha-blockers, diuretics or steroids

Treating high triglycerides levels

There are a number of treatments that may be recommended by a doctor to help you lower your triglyceride levels.

Statins

Statins are one of the most commonly prescribed medications, with in excess of 58 million prescriptions issued annually in the UK. It is usually prescribed to treat high cholesterol, and can also be a useful treatment for lowering triglyceride levels.

The most popular types of statin medications available are Simvastatin, Crestor, Fluvastatin, Lipitor, Pravastatin, Atorvastatin, Lescol, Lipostat, Zocor. They all work in largely the same way, but their strengths do vary. Statins are easily consumed by taking a tablet once a day. It is usually advised that you take them at the same time each day, for example just before bed. Your doctor will help you choose the right statin medication for you.

Other Medications

Aside from statins, there are a number of other medications, usually reserved for people with triglyceride levels in excess of 500 mg/dl. These include:

Fibrates such as fenofibrate and gemfibrozil which are effective in lowering triglyceride levels in excess of 500mg/dl. Increased side-effects can be experienced when these are combined with statins, in particular, the risk of developing a serious muscle problem called rhabdomyolysis which can lead to kidney failure. You should ensure that you advise your healthcare professional of any other medications you are taking before considering fibrates.

Niacin which is also known as nitric acid, is another medication that can be effective in lowering very high triglyceride levels. Niacin can negatively interact with a number of other medications, increasing the risk of adverse side effects, so again you must talk your doctor about any other medications you're taking before use.

Fish Oils, such as Omega 3 fatty acids can help lower your triglyceride levels. High dosages are required for this to be effective, so it is usually only recommended for people diagnosed with triglyceride levels of 500mg/dl or higher.

Preventing high triglycerides levels

There are a number of lifestyle improvements you can make to help prevent and manage high triglyceride levels:

  • Reduce your calorie intake: The NHS recommend a daily calories intake of 2,500 Kcal for a man and 2,000 Kcal for a woman, within a healthy balanced diet
  • Lose excess weight: If you're overweight, even losing 5 to 10 pounds can have an impact on lowering your triglyceride levels
  • Make healthier eating choices: Avoid processed foods and sugars and choose healthier fats such as nuts, olive oil and fish
  • Reduce your alcohol intake: Alcohol is high in sugar and fats, meaning even small quantities can impact your triglyceride levels
  • Get regular exercise: The NHS recommend a minimum of 2 ½ hours of moderate aerobic activity each week. This can be broken out into smaller intervals of 10 minutes or more during the week. Even a small change can have a big impact on your heart health.
  • Stop smoking: Studies have shown that non-smokers have lower triglyceride levels than non-smokers – 38.4mg/dl lower on average.

Diagnosing and treating high triglyceride levels

Those suffering from high cholesterol levels also have a high chance of having high triglyceride levels. To confirm whether or not an individual has an unhealthy level of triglycerides, it is best to consult a doctor who will run a blood test to confirm it.

It is likely that the course of treatments prescribed to treat high cholesterol will also help in reducing overall triglyceride levels as high triglyceride amounts are usually attached with LDL cholesterol and if these are reduced through exercise, healthy eating and prescription medication, then the level of triglycerides in the body will also be reduced.